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Diagnosing borderline personality. A pilot study using multiple diagnostic methods

O F Kernberg, E G Goldstein, A C Carr

    The Journal of Nervous and Mental Disease
    |April 1, 1981
    PubMed
    Summary
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    The structural interview effectively differentiates borderline personality organization using identity, defense, and reality testing. This method shows promise for diagnosing severe character pathology.

    Area of Science:

    • Psychiatry
    • Psychology
    • Psychoanalysis

    Background:

    • Distinguishing personality organization levels (neurotic, borderline, psychotic) is crucial for treatment.
    • Existing diagnostic methods may not fully capture the nuances of borderline personality organization.

    Purpose of the Study:

    • To introduce and validate a novel

    Main Methods:

    • Development of a "structural" interview focusing on here-and-now patient-interviewer dynamics.
    • Assessment of three structural criteria: identity integration, defensive operations, and reality testing.
    • Comparison of structural interview diagnoses with other methods (Gunderson's, psychological tests, clinical diagnoses) in 48 hospitalized patients.

    Main Results:

    Related Experiment Videos

    • Substantial agreement was found between the structural interview and other diagnostic methods.
    • The structural interview may identify a distinct dimension of personality functioning in borderline diagnoses.
    • Borderline structural diagnoses align with severe character pathology, distinct from schizophrenic disorders.

    Conclusions:

    • The structural interview is a promising tool for personality disorder diagnosis and research.
    • Its utility in differentiating borderline personality organization warrants further investigation.
    • This approach may aid in understanding prognosis and treatment for severe character pathology.